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Organization

FOSSIL CREEK FAMILY MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID WAYNE SIMONAK DO (OWNER)
(817) 498-1818
Entity
Organization

Contact information

Practice address
7510 N BEACH ST, FORT WORTH, TX 76137
(817) 498-1818
(817) 581-3761
Mailing address
7500 N BEACH ST, FORT WORTH, TX 76137-1505
(817) 498-1818
(817) 581-3761

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121142701
TX
Enumeration date
10/11/2006
Last updated
03/15/2019
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